Incidence and predisposing factors of postoperative infection after rhinoplasty based on 2630 cases.

Background This study evaluates the incidence and clinical characteristics of postoperative infection following primary and revision rhinoplasty.

Method This is a retrospective review of 2630 cases of rhinoplasty by a single surgeon (YJ Jang), from July 2003 to June 2018. 1595 (69.9 %) were male, 687 (30.1 %) were female. The median age was 31. The incidence of infection was compared between the primary and revision surgeries and analyzed according to the grafts or implant used. We also evaluated the organisms cultured and the time between surgery and the development of infection.

Result This study includes 2134 primary and 496 secondary cases. Costal cartilage was used in 413 cases, conchal cartilage in 572, homologous fascia lata in 829, homologous costal cartilage in 102, GoreTex in 373, and silicone in 32 cases. We identified 22 cases (0.84 %) of postoperative infection. Of these, 18 cases were secondary (81.8 %). 3 cases had simultaneous correction of a septal perforation (13.6 %). Autologous costal cartilage was utilized in 14 of the infected cases, conchal cartilage in 6, homologous fascia lata in 13, homologous costal cartilage in 1, GoreTex in 5 and silicone in 3 cases. Out of the 22 cases of infection, in 11 cases (50 %) the infection developed within 1 month following surgery (12±7 days). MRSA was cultured in 8 cases. Infection manifested as nasal tip erythema in 45 % of cases. For control of infection, surgical debridement was undertaken in 20 cases.

Conclusion Revision rhinoplasty requiring the use of costal cartilage or simultaneous correction of septal perforation showed a higher risk of post-rhinoplasty infection, which usually manifests as erythema and swelling of the nasal tip and the caudal septum and needs to be managed by surgical debridement.

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Publication History

Article published online:
10 June 2020